Comparison of Upper Lip Bite Test (A New Simple Technique) With Mallampati Test for Predicting Difficulty in Endotracheal Intubation in Pakistani Population

Abstract

Objective:

To determine the diagnostic accuracy of upper lip bite test for predicting difficulty in endotracheal intubation by taking Cormack Lehane classification as gold standard.

Material and Methods:

It was a cross sectional validational study conducted on 212 patients that underwent general anesthesia from 1^st July 2015 to 31^st December 2015 at Indus Hospital. Upper lip bite test was performed prior to surgery and then Cormack and Lehane classification was used to predict difficult intubation on induction of general anesthesia during conventional laryngoscopy.

Results:

Overall area under the ROC curve (AUC) of upper lip bite test (ULBT) was 71.8% with diagnostic accuracy of 85% inferring that ULBT is a fair test. However, the sensitivity of ULBT was found to be 51.3% suggesting that the test is not good enough to correctly identify patients with difficult intubation

Conclusion:

It is therefore concluded from our study that upper lip bite test may be a good predictor for easy intubation but alone it cannot be used as a sole predictor for difficult intubation rather it should be used in combination with other bedside technique to increase accuracy of prediction difficult intubation.